From the Guidelines
To manage a blistered toe and prevent infection, it is crucial to prioritize proper wound care and prevention strategies, focusing on keeping the area clean, reducing pressure, and monitoring for signs of infection, as neglecting these steps can lead to severe complications, including foot ulcers, especially in individuals with diabetes, as emphasized by recent guidelines 1.
When dealing with a blistered toe, the initial step involves gentle cleaning of the area with mild soap and water. If the blister is small and not painful, it is advisable to leave it intact, as the skin acts as a natural barrier against infection. However, for painful or large blisters, draining the fluid after sterilizing a needle with alcohol and making small holes at the blister's edge can provide relief. Following drainage, applying an antiseptic like povidone-iodine (Betadine), covering with an antibiotic ointment such as Neosporin or Polysporin, and using a sterile bandage or adhesive bandage are recommended steps. Daily dressing changes or changes when the dressing becomes wet or dirty are essential for promoting a clean environment conducive to healing.
Key strategies to prevent infection and promote healing include:
- Keeping the area clean and covered
- Reducing pressure on the blistered area, for example, by using donut-shaped moleskin pads
- Monitoring for signs of infection, such as increased pain, redness, warmth, swelling, or pus
- Wearing properly fitting shoes to avoid further irritation
- Using moisture-wicking socks to keep the foot dry
- Applying petroleum jelly to friction-prone areas
- Utilizing blister prevention products like Body Glide or moleskin on areas commonly affected by blisters
Given the potential for severe complications, especially in diabetic patients, as outlined in the guidelines for the prevention of foot ulcers in persons with diabetes 1, it is essential to educate individuals at risk on proper foot self-care, including daily foot examinations, appropriate footwear, and the importance of seeking medical advice at the first sign of a pre-ulcerative lesion or other foot issues. This proactive approach can significantly reduce the risk of morbidity, mortality, and impact on quality of life associated with foot ulcers and infections.
From the Research
Types of Issues from a Blistered Toe
- Infection: A blistered toe can become infected, leading to conditions such as cellulitis or abscess, which can be caused by bacteria like Staphylococcus aureus, Streptococcus pyogenes, and other β-hemolytic streptococci 2.
- Delayed healing: If the blister becomes infected, it can delay the healing process, and in some cases, may require medical attention.
- Increased risk of complications: People with certain medical conditions, such as diabetes, may be more prone to complications from a blistered toe, including infection and delayed healing 3.
Managing a Blistered Toe and Preventing Infection
- Keeping the area clean and dry can help prevent infection.
- Applying antibiotic ointment and covering the blister with a bandage can also help prevent infection.
- In some cases, anti-inflammatory medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be used as adjunct treatment to improve clinical response, although the evidence is limited 4, 5.
- It is essential to seek medical attention if the blister becomes infected or does not heal properly, as this can lead to more severe conditions like cellulitis or abscess, which may require antibiotic treatment or incision and drainage 2, 6.
Preventing Infection
- Practicing good hygiene, such as washing hands regularly, can help prevent the spread of infection.
- Avoiding sharing personal items, such as towels or razors, can also help prevent the spread of infection.
- Keeping the blistered toe clean and dry, and applying antibiotic ointment, can help prevent infection.
- Seeking medical attention if the blister becomes infected or does not heal properly can help prevent more severe conditions like cellulitis or abscess.